2023-11-13T13:43:17-06:00 2022-12-31 611436956 NOVAK FRANCELLA LLC 40 MONUMENT RD 5TH FLR BALA CYNWYD PA 19004 990 2022-01-01 066069081 UFCW AND PARTICIPATING EMPLOYERS NEW ENGLAND HEALTH FUND UFCW 2032264751 PO BOX 5160 WESTPORT CT 068809917 RONALD PETRONELLA UNION TRUSTEE 2032264751 2023-11-13 1 RONALD PETRONELLA 999009999 0 LOUIS VERZELLA CPA P00360279 6106689400 2023-11-13 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z RONALD PETRONELLA PO BOX 5160 WESTPORT CT 068809917 140136958 0 X WWW.UFCWNEWENGLANDHEALTHFUND.COM X 1959 CT THE PURPOSE OF THIS TRUST SHALL BE TO PROVIDE SUCH HEALTH AND WELFARE BENEFITS AS MAY BE AUTHORIZED OR PERMITTED BY LAW, WHICH MAY INCLUDE BUT IS NOT LIMITED TO DEATH BENEFITS, MEDICAL, HOSPITAL, SURGICAL, DENTAL, VISION AND PRESCRIPTION DRUG BENEFITS, EDUCATION BENEFITS AND SAFETY AND HEALTH TRAINING TO QUALIFIED PARTICIPANTS AND BENEFICIARIES IN THE AMOUNTS AND UNDER THE CONDITIONS SPECIFIED IN THE PLAN OF BENEFITS. 10 1 10 0 0 0 0 0 131232505 110809387 5080382 183597 6277814 8551068 142590701 119544052 0 0 147324008 135344900 1097195 803339 0 0 0 2004015 4980661 150425218 141128900 -7834517 -21584848 128548713 102915649 12362658 12938092 116186055 89977557 X THE PURPOSE OF THIS TRUST SHALL BE TO PROVIDE SUCH HEALTH AND WELFARE BENEFITS AS MAY BE AUTHORIZED OR PERMITTED BY LAW, WHICH MAY INCLUDE BUT IS NOT LIMITED TO DEATH BENEFITS, MEDICAL, HOSPITAL, SURGICAL, DENTAL, VISION AND PRESCRIPTION DRUG BENEFITS, EDUCATION BENEFITS AND SAFETY AND HEALTH TRAINING TO QUALIFIED PARTICIPANTS AND BENEFICIARIES IN THE AMOUNTS AND UNDER THE CONDITIONS SPECIFIED IN THE PLAN OF BENEFITS. 0 0 TO PROVIDE BENEFITS FOR THE MEMBERS WHO PARTICIPATE IN THIS FUND. 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 10 1 0 0 0 0 0 0 0 0 X 10 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 X BARBARA FEDUMENTI 2032264751 290 POST ROAD WEST WESTPORT CT 068810470 RONALD PETRONELLA UNION TRUSTEE 2.00 40.00 X 0 263351 31787 JASON PARADIS EMPLOYER TRUSTEE 2.00 X 0 0 0 PAT DURNING EMPLOYER TRUSTEE 2.00 X 0 0 0 BOB SPINELLA EMPLOYER TRUSTEE 2.00 X 0 0 0 MARK ESPINOSA UNION TRUSTEE 2.00 40.00 X 0 270361 3352 CHRISTA KRAMER EMPLOYER TRUSTEE 2.00 X 0 0 0 FERNANDO LEMUS UNION TRUSTEE 2.00 40.00 X 0 171932 28651 TIM MELIA UNION TRUSTEE 2.00 40.00 X 0 206932 32260 SUSAN SANVILLE EMPLOYER TRUSTEE 2.00 X 0 0 0 JEFF JONES UNION TRUSTEE 2.00 40.00 X 0 112731 14655 BARBARA FEDUMENTI PLAN EMPLOYEE 40.00 0.00 X 143015 0 13895 143015 1025307 124600 1 0 1 0 ANTHEM HEALTH PLANS INC 3075 VANDERCAR WAY CINCINNATI OH 45209 CLAIMS PROCESSING 2462222 UNION PRINTING INC 45 WESTBRIDGE DR WATERBURY CT 06708 DUPLICATING & MAILINGS 301208 LIVONGO HEALTH INC 150 W EVELYN AVE 150 MOUNTAIN VIEW CA 94041 CLAIMS PROCESSING 290421 THE SEGAL COMPANY 333 WEST 34TH STREET NEW YORK NY 10001 ACTUARY/CONSULTANT 280235 NOVAK FRANCELLA LLC 40 MONUMENT RD 5TH FLOOR BALA CYNWYD PA 19004 ACCOUNTANT 141423 7 EMPLOYER CONTRIBUTIONS 525100 99820137 99820137 PARTICIPANT AND RETUREE CONTRIBUT 525100 10989250 10989250 110809387 2366617 2366617 18409886 20592906 -2183020 -2183020 -2183020 PRESCRIPTION REBATES 525100 7939135 7939135 CLAIMS SUBROGRATION RECOVERY 525100 608000 608000 MISCELLANEOUS 525100 3933 3933 8551068 119544052 119356522 0 187530 135344900 564826 91600 99349 47564 85884 141423 65696 3298876 436224 155543 246994 21148 5245 79775 UFCW LOCAL 919 PENSION 442424 CONNECTICUT PERSONAL PR 1429 141128900 41162976 29199218 6916762 4468582 211976 195933 15162 16043 69181903 57870080 11271910 11361726 128548713 102915649 184906 306285 325396 12177752 12306411 12362658 12938092 X 0 0 0 0 116186055 89977557 116186055 89977557 128548713 102915649 X -21584848 -6764770 2141120 X X 0 1 X 1 0 194702 178659 16043 17274 17274 0 16043 WHOLLY-OWNED SUBSIDIARY - REAL ESTATE PROPERTY 8651318 C REAL ESTATE INVESTMENT FUND - PARTNERSHIP 2610408 C OTHER FOREIGN BONDS 100000 C 11361726 DEPOSIT FROM STOP AND SHOP 200000 BENEFIT OBLIGATION 12106411 12306411 X 112713586 -6764770 -6764770 119478356 65696 65696 119544052 140934545 0 140934545 65696 128659 194355 141128900 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE FUND MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FUND AND RECOGNIZE A TAX LIABILITY IF THE FUND HAS TAKEN AN UNCERTAIN POSITION THAT, MORE LIKELY THAN NOT, WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE U.S. FEDERAL, STATE, OR LOCAL TAXING AUTHORITIES. THE FUND IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. TYPICALLY, PLAN TAX YEARS WILL REMAIN OPEN FOR THREE YEARS; HOWEVER, THIS MAY DIFFER DEPENDING UPON THE CIRCUMSTANCES OF THE PLAN. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGES IN BENEFIT OBLIGATIONS 128,659. 0 0 0 RONALD PETRONELLA UNION TRUSTEE 0 263351 0 0 0 0 0 15631 0 16156 0 295138 0 0 MARK ESPINOSA UNION TRUSTEE 0 270361 0 0 0 0 0 0 0 3352 0 273713 0 0 TIM MELIA UNION TRUSTEE 0 193233 0 0 0 13699 0 13842 0 18418 0 239192 0 0 FERNANDO LEMUS UNION TRUSTEE 0 171932 0 0 0 0 0 0 0 28651 0 200583 0 0 BARBARA FEDUMENTI PLAN EMPLOYEE 143015 0 0 0 0 0 3159 0 10736 0 156910 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PRESENTED TO THE BOARD OF TRUSTEES FOR REVIEW AND APPROVAL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH TRUSTEE MUST SIGN A STATEMENT ANNUALLY THAT STATES HE/SHEE UNDERSTANDS THE CONFLICT OF INTEREST POLICY AND WILL COMPLY WITH THE POLICY. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DUCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: TRANSFER OF ASSETS TO THE UFCW AND PART. EMPLOYERS NEW ENGLAND HEALTH FUND 2,141,120. FORM 990, PART XII, LINE 2C: BOARD OF TRUSTEES IS RESPONSIBLE FOR OVERSIGHT OF THE AUDIT AND SELECTION OF INDEPENDDENT ACCOUNT. NO CHANGE FROM PRIOR YEAR. 290 POST ROAD WEST CORP 290 POST ROAD PO BOX 470 WESTPORT CT 068810470 061318049 TITLE HOLDING CORP CT 501(C)(2) 0 UNITED FOOD & COMMERCIAL WORKERS LOCAL 371 290 POST ROAD PO BOX 470 WESTPORT CT 068810470 060605499 LABOR ORGANZIATION CT 501(C)(5) 0 UNITED FOOD & COMMERCIAL WORKERS LOCAL 328 278 SILVER SPRING STREET PROVIDENCE RI 02904 050227658 LABOR ORGANZIATION RI 501(C)(5) 0 UNITED FOOD & COMMERCIAL WORKERS LOCAL 1445 30 STERGIS WAY DEDHAM MA 02026 041768085 LABOR ORGANZIATION MA 501(C)(5) 0 UNITED FOOD & COMMERCIAL WORKERS LOCAL 1459 33 EASTLAND STREET SPRINGFIELD MA 01109 042220774 LABOR ORGANZIATION MA 501(C)(5) 0 UNITED FOOD & COMMERCIAL WORKERS LOCAL 919 6 HYDE ROAD FARMINGTON CT 06032 060721822 LABOR ORGANZIATION CT 501(C)(5) 0 ACME ALBERTSON'S SAFEWAY BAKER COMMODITIES INC BCBL BOGNER'S OF MANCHESTER BOGOPA CARL'S BONED CHICKEN CHARTWELLSNORTON CHARTWELLSSACRED HEART CHARTWELLSSEEKONK CITY PACKING COMPANY INC DURHAM SCHOOL SERVICES FIRST TRANSIT FORZA GROUP GORTONS HARBORSIDE WILLOWS HEALTH CARE HARTFORD PROVISION BRISTOL HOT TOPS KINGS SUPER MARKET MANCHESTER PACKING OCEAN STATE CULTIVATORS PHOENIX MANAGEMENT INC SPRINGFIELD AREA TRANSIT SPORTS SERVICE DD SR GARAFOLOMILFORD SR JOSEPH STAMFORD PLAZA & HOTEL STOP & SHOP STUDENT TRANSPORTATION OF AMERICA UMASS DARTMOUTH TRIAD LOGISTICS WATERBURY EXTAPPLE HEALTH WHITNEY MANOR WORK OPPORTUNITY CENTER INC 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 290 POST ROAD WEST CORP K 262694 FMV